一名患有慢性髓性白血病的儿科患者在腹腔镜脾切除术后发生脾静脉和门静脉血栓形成。
Splenic and portal vein thrombosis following laparoscopic splenectomy in a pediatric patient with chronic myeloid leukemia.
作者信息
Lederman Henrique Manoel, Fieldston Evan
机构信息
The Children's Hospital of Philadelphia, 34th Street & Civic Center Boulevard, Philadelphia, PA, USA.
出版信息
Sao Paulo Med J. 2006 Sep 7;124(5):275-7. doi: 10.1590/s1516-31802006000500008.
INTRODUCTION
Splenic or portal vein thrombosis is a rare complication following splenectomy.
CASE REPORT
We report a case of splenic and portal venous thrombosis in a 10-year-old girl with chronic myeloid leukemia who underwent laparoscopic splenectomy prior to bone marrow transplant. Clinical suspicion of such thrombosis should be high for patients who have had splenectomy. The diagnosis is confirmed by Doppler ultrasound or contrast-enhanced computed tomography; magnetic resonance imaging magnetic resonance angiography or arteriography can also be used. Proposals for postoperative screening protocols are discussed. Patients with primary myeloproliferative disorders are at increased risk of portal vein thrombosis, independent of surgical intervention, perhaps due to platelet dysfunction resulting from abnormalities of pluripotent stem cells. Marked splenomegaly (with larger draining veins) is thought to increase the risk of thrombosis.
引言
脾静脉或门静脉血栓形成是脾切除术后一种罕见的并发症。
病例报告
我们报告了一例10岁慢性髓性白血病女孩在骨髓移植前行腹腔镜脾切除术后发生脾静脉和门静脉血栓形成的病例。对于接受过脾切除术的患者，临床应高度怀疑此类血栓形成。通过多普勒超声或增强计算机断层扫描确诊；也可使用磁共振成像、磁共振血管造影或动脉造影。讨论了术后筛查方案的建议。原发性骨髓增殖性疾病患者门静脉血栓形成的风险增加，与手术干预无关，这可能是由于多能干细胞异常导致血小板功能障碍。明显的脾肿大（伴有较大的引流静脉）被认为会增加血栓形成的风险。
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